Change Management in the Practice

“If I were in charge here, I would change …” How many times have you thought this when you knew there was a better way to accomplish a task? The funny thing is that many of us are in a position to help facilitate change if not directly instigating the change. Yet, how many times do we find ourselves resisting change? It is ingrained into us to resist change.

There is a great story about Willie B. He was a gorilla that lived at the Atlanta Zoo in isolation for 27 years with a tire swing and television set to keep him company. Finally, some supporters were able to raise the funds to develop an outside natural style setting for him. When they opened the doors he could see the trees and grass for the first time, but was afraid to move. He was only willing to put his paw out in the sunshine and let the sun on his hand for the first time. He could see that it was better, but he was afraid of change. Finally Willie B. ran into the sunshine and never looked back. He was able to raise a family and lived to the age of 41. Willie B. initially resisted change even though he could see it was better than what he had, we as humans tend.

Humans try to reduce stress and uncertainty by establishing routines. Sometimes even when we know that a change is needed, we still work really hard to keep things the same way they have always been done. Right now, everyone is talking about how we must change healthcare. There are many ideas floating around on how to make this change. Some new ideas include the medical home or transforming practices. They all seem to follow the basic principal that a change is needed. In many cases a change is needed, but it is always good to remember not to throw the baby out with the bath water. There will always be some things that you will want to keep and others that may need to altered.

Some of the staff will immediately jump on board and others will be drugged through a change kicking and screaming the entire way if you are not careful. How can this be avoided? The best way is to gain their involvement. In order for a change to be successful and not a temporary band-aid, Everone needs to be a part of the change process.

If this is a small practice, then it is easy to allow everyone to get together and brainstorm. If it is a larger organization it may be necessary to have group representatives that can be counted on to go back and keep their group updated and involved in the process. By allowing the entire group to be a part of the process it reduces their resistance to change and allows them to feel a part of the process.

Together begin with the end in mind, that is figure out where you want to be. What goal is it that you need to achieve? Maybe you want to make sure that patients are being contacted properly regarding tests or maybe you want to reduce patient wait times. Figure out what the goal will be and then establish the parameters and measurements needed to achieve the goal. How long do you need to reach the goal realistically? How will you know when you have reached it? Make a plan of action and allow the group to brainstorm to determine steps and measurements for the goal.

Most humans tend to have problems with only long-term goals. If you have small goals within the large goal it often makes it easier to achieve the ultimate prize. Look at it this way, to win at the Olympics you have to win at national events. To win at national event you have to win at regional events. To win at regional, you had to win at local events. To win at each event, you had to practice until you were good enough to win. Your ultimate goal was to win at the Olympics, but you had a lot of small wins leading up to the final goal. You would have started by establishing your baseline and along the way you would have continually measured and checked your progress. To reach your goal in change management in the practice you will want to do the same thing.

Sometimes, we start out with one goal in mind and find along the way that it isn’t going to work. By measuring and evaluating along the process you will be able to see if something is working or needs to be dropped and a new goal put into place. Life is all about change and how we handle it. We can let change frighten us or bring us down or embrace it as Willie B. did and go out into the sunshine and live life to it's fullest.

References http://www.zooatlanta.org/animals_willieb.htm